Learning Lessons from the Past

As CEO, I’m often asked how I can be across a $1.4b organisation which employs 6500 people and delivers thousands of patient interactions every day. The answer is that I can’t.

I see my role as empowering you and giving you the opportunity to do the right thing in the right way. I truly believe that we are all here because of our common sense of purpose and our values, and that these are reflected in our practice given the opportunity. With that in mind, I want to share with you some guiding principles from one of the world’s leading healthcare experts on quality improvement.

Many of you will remember Don Berwick, who spent some wonderful days with us last year attending APAC and holding a session for staff in Ko Awatea.  The former President and CEO of the Institute for Healthcare Improvement has a long list of accolades to his name which are testament to his wisdom and expertise. Those who were at APAC last year will recall his profound keynote speech in which he talked about his commitment to care for patients and his experience of medical error while working as a registrar in the 1970s. Almost a year later, I still remember just how moving his words were.

You also probably remember the tragedy at Stafford Hospital (Mid Staffs) in the UK, which I blogged about in April . As I discussed at the time, the Mid Staffs story really speaks to organisational culture and the tragic outcomes that can happen when an organisation loses its moral compass. As the extent of the suffering has become clear, various enquiries have been set up in the UK to determine just how the system failed so extensively. More recently, the British Government commissioned Don Berwick to bring his wisdom to bear on the case. Don’s report, which I would encourage you to read by clicking here, mentions four principles I’d like to share.

Don’s aim in developing the four principles was to help the UK’s NHS move towards better, safer care, but I think you’ll agree they have a much broader application. The report talks about the NHS as a learning organisation being fully committed to:

  1. Placing the quality of patient care, especially patient safety, above all other aims.
  2. Engaging, empowering and hearing patients and carers throughout the entire system and at all times.
  3. Fostering whole-heartedly the growth and development of all staff, including their ability and support to improve the processes in which they work.
  4. Embracing transparency unequivocally and everywhere, in the service of accountability, trust and the growth of knowledge.

I find these principles very profound and think they closely align to the kind of culture we often talk about at CM Health. Regardless of where we are in the world or what kind of situation we work in, be it private or public, acute or elective, in a developed or developing country (think of Atul Gawande and the work that is happening in India), I just keep coming back to how important these guiding principles are. If we can follow these while embracing the Granny Test, we will achieve excellence and retain that moral compass that was so thoroughly lost in Mid Staffs.



Author: Geraint Martin

Geraint Martin was appointed Chief Executive Officer of Counties Manukau DHB in December 2006. It is one of the largest District Health Boards in New Zealand and services a population of half a million. He has significant experience over 30 years in national policy & in managing both primary and secondary care . Previously, he was Director of Health and Social Care Strategy at the Welsh Government .He authored a radical 10 year strategy of reform, including the successful “Saving 1000 lives” Campaign.Until 2004, he was CEO at Kettering General Hospital & had held senior positions in London & Birmingham.He has worked closely with clinicians in improving clinical standards,patient safety,chronic disease management & managing acute care to reduce hospital demand.In NZ, He has promoted clinical quality and leadership as central to improving patientcare. This has led to a significant increases in productivity and access, whilst maintaining financial balance. CMH has completed in 2014 a $500 m capital redevelopment programme, the largest in New Zealand. A central part of this is the establishment of Ko Awatea,the Centre for Innovation and Research which will underpin CMH as one of the the leading health systems in Australasia.In 2008, he chaired the Ministerial Review of Emergency Care in New Zealand, and in 2013 was an member of the Expert Advisory Panel on Health Sector Performance. Geraint has an MSc in Health Policy from Birmingham University .His post-graduate work has focused on health economics and Corporate Strategy . He is adjunct Professor of Healthcare Management at AUT and Victoria University, Wellington Elected in 2006 as a Companion of the Institute of Healthcare Management, previously he was an Associate Fellow at Birmingham University.He is is Chair of the Auckland Philharmonia Orchestra, a member of the Institute of Directors, on the Board of the NZ Institute of Health Management & previously the Board of The NZ Health Quality and Safety Commission.

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